Brain Tumor Patient Calculates Simple Math Problems during Awake Craniotomy

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Mahesh Dixit (Name Changed) teacher by profession 56 Years old, suffering from neurodisorder underwent a unique surgery called awake craniotomy. This brain surgery was performed to treat brain tumors close to highly functional brain areas like motor/ language area. The surgery is also the treatment of choice for some neurological conditions including epileptic seizures. Performing these surgeries under routine anesthesia risks permanent damage to these areas due to surgical handling and patients waking up with neurodeficits like speech problems/ hemiparesis.

Jupiter Hospital, recently performed a similar procedure successfully on a patient- teacher by profession with a left temporo-parietal brain tumor, very close to language reception area (Wernicke’s area).

The patient was cooperative and agreed for awake craniotomy after having learnt about the risks involved in routine surgery. Navigation guided surgery under continuous neuro monitoring was carried out by team of doctors including – neurosurgeon- Dr. Dhakoji,a nesthetist- Dr. Anmol, Dr. Bhagyashree, speech therapist- and electrophysiologist.

“The crucial language areas responsible for comprehension of spoken words, calculations, and identifying objects were painstakingly identified by asking a set of questions to the patient as well as stimulating his brain simultaneously with a bipolar stimulator,” said Dr. Amit Dhakoji who has over 13 years of experience in performing such high-end brain surgeries.

If we reach very close to these areas and patient starts having difficulty, surgery can be stopped and continued after few minutes or at a different site, he further added.Thus, the concept of “maximal safe resection”, without harming the patient can be realized using awake craniotomy.

The surgery was delicately planned to the last detail through the language negative areas of the brain with continuous monitoring of language function during the entire procedure. Maximal possible resection of tumor was accomplished during surgery.

On 3rd postoperative day, patient experienced difficulty in speaking and calculating simple mathwhich was attributed to post-operative edema. However, the difficulty subsided with a short course of steroids and was followed by discharge on 6th post-operative day. On his last follow-up, the patient didn’t have any such difficulties and was recovering as per plan.

Jupiter Hospital is proud to perform such a high-end surgery and dedicates its success to the entire team, an educated and co-operative patient in addition to the state-of-the-art OT setup available at the Hospital.


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